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Apoptosis in breast cancer and its relationship to clinicopathological characteristics and prognosis
Author(s) -
Nishimura Reiki,
Nagao Kazuharu,
Miyayama Haruhiko,
Matsuda Masakazu,
Baba Kenichirou,
Matsuoka Yukio,
Yamashita Hiroya,
Fukuda Makoto,
Higuchi Akihiro
Publication year - 1999
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199908)71:4<226::aid-jso4>3.0.co;2-0
Subject(s) - apoptosis , tunel assay , comedo , terminal deoxynucleotidyl transferase , breast cancer , h&e stain , medicine , cancer , pathology , cancer research , staining , biology , ductal carcinoma , biochemistry
Background and Objectives Apoptosis is essential to maintain homeostasis in living organisms and occurs in a variety of tissues in response to both physiological and pathological stimuli. In breast cancer, most cytotoxic drugs and hormonal treatments induce apoptosis. We studied the relationships between apoptosis and clinicopathological variables or prognosis in 143 patients with operable breast cancer. Methods Apoptosis was numerically graded in 5 consecutive 40× high‐power fields (HPF) of hematoxylin‐eosin (H&E) stained sections, since we showed that there was a significant correlation of H&E staining with terminal deoxynucleotidyl transferase‐mediated dUTP‐biotin nick end labeling (TUNEL) staining. Results The average number of apoptotic cells was 19.9 (0∼168)/5 HPF, and cases were classified into 3 groups based on the number of apoptotic cells/5HPF: 0 to 10, 11 to 30, and 31+. The level of apoptosis increased with increasing size of the tumor, and apoptosis was rarely seen in tumors with positive ER or lower proliferative activity, as assessed by DNA polymerase α. As shown by DNA content analysis, apoptotic cells were observed more frequently in tumors with low G1 and high S‐phase fractions. In addition, apoptosis was correlated with overexpression of p53 and poor prognosis. Although apoptosis did not correlate with EIC (extensive intraductal component) status, tumors with comedo component had higher values of apoptosis than those without comedo component. Conclusions In breast cancer, apoptosis might reflect biological behavior, namely a higher degree of biological aggressiveness and unfavorable prognosis. J. Surg. Oncol. 1999;71:226–234. © 1999 Wiley‐Liss, Inc.